Commitment
For Healthcare Professionals
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Demonstrate dedication to and accountability for optimizing antibiotic prescribing and patient safety.
| Reference | Interventions and Outcomes | Methods, Participants, and Settings | Results | Conclusions |
|---|---|---|---|---|
| Meeker D, et al. Nudging guideline-concordant antibiotic prescribing: A randomized clinical trial. JAMA Intern Med 2014. 174(3):425–31. | Interventions
• Poster containing a public commitment to use antibiotics judiciously with clinician picture and signature displayed in examination rooms at point of clinician-patient encounter Outcomes • Antibiotic prescribing rates for acute respiratory infections (ARIs) for which antibiotics are inappropriate |
Method
• Randomized clinical trial Participants • 15 primary care providers Setting • 5 primary care clinics in the United States |
• 954 adults with ARI
• Poster group had a 19.7% decrease in inappropriate prescribing for acute respiratory infections compared with controls, p = 0.02, controlled for baseline rates of antibiotic prescribing. |
• Public commitments in a poster are a low-cost intervention that can result in reduced inappropriate prescribing. |
| Pollack LA, et al. Antibiotic stewardship programs in U.S. acute care hospitals: findings from the 2014 National Healthcare Safety Network (NHSN) Annual Hospital Survey. Clinical Infectious Diseases 2016; 63:443-9
|
Interventions
• No intervention; observational study Outcomes • Level of variability in antibiotic stewardship programs (ASPs) by hospital characteristic and location
|
Method
• Observational study Participants • Hospitals enrolled in the National Healthcare Safety Network Setting • 2014 National Healthcare Safety Network Annual Hospital Survey
|
• 4184 US hospitals
• On self-report, 39% of hospitals have an ASP meeting all 7 CDC defined core elements of inpatient antibiotic stewardship. • 59% of hospitals with more than 200 beds (59%) had an ASP meeting all Core Elements • 25% of hospitals with less than 50 beds had an ASP meeting all Core Elements • States reporting a percentage of hospitals with all 7 core elements ranged from 7% to 58%. • Written support and salary support for ASP were significantly associated with having an ASP meeting all Core Elements. |
• There is wide variability with ASP implementation.
• Hospital leadership support appears crucial for comprehensive ASPs • ASPs can be established in hospitals of all sizes. |
- Page last reviewed: April 17, 2015
- Page last updated: May 12, 2017
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